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General NPI Number Information
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NPI Number | 1942600457
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Entity Type | Organization
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Legal Business Name | ITALCOL, INC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 6655 WEST SAHARA AVE SUITE B200
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City | LAS VEGAS
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State | NV
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Zip | 89146
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Country | US
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Telephone | 702-222-4061
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Fax | 702-974-1652
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Provider Business Mailing Address
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Address Line | 6655 WEST SAHARA AVE SUITE B200
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City | LAS VEGAS
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State | NV
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Zip | 89146
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Country | US
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Telephone | 702-222-4061
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Fax | 702-974-1652
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Authorized Official
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Title or Position | SR. VOCATIONAL CONSULTANT
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Name | MRS. VERIUSKA V CORSO
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Credential | CDMS
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Telephone | 702-496-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | NV20061221497
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License Number State | NV
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